Professor Amanda Baker

Research of substance

Professor Amanda Baker is a National Health and Medical Research Council Senior Research Fellow at the University of Newcastle. An award winning innovator, she specializes in the treatment of co-existing mental health and substance use problems.

Early in her career as a clinical psychologist, Professor Baker identified a lack of integration between mental health supports, and drug and alcohol treatments as a major barrier to behaviour change.

Rather than treating co-occurring problems in a consolidated manner, patients were often refused treatment from one targeted service, if they also needed treatment from the other.

"What drives me are the dualities in the system between mental health and drug and alcohol," Amanda explains.

People often have more than one problem, and mental health and drug and alcohol use go hand in hand.

Over one hundred and fifty publications later - including five national amphetamine treatment clinician guidelines and eight treatment manuals for comorbidity - Amanda and her team have made significant progress toward the recognition of the need to integrate the treatment of co-existing issues.

INTEGRATION AND COMMUNITY

By the time Amanda graduated in the early 1980s, the push to de-institutionalise mental health in Australia had begun in earnest. Research and practice from around the world showed that mental health patients, who had previously been institutionalised, had better health outcomes when transitioned back
into the community.

A stint practicing in community health in Manchester, the United Kingdom, gave Amanda a new perspective on how psychologists could successfully aid this transition. During this time, Amanda experienced first-hand the positive outcomes of a system where practice and research were highly integrated,
and was eager to facilitate a change in this direction back home.

Returning to Australia three years later, Amanda took up a position at the National Drug and Alcohol Research Centre, where she completed her PhD on reducing HIV risk in injecting drug users, before working in the drug and alcohol facility at Westmead Hospital, Sydney.

In 1995 Amanda was appointed to head up a graduate course in Drug and Alcohol Studies for clinicians at the University of Newcastle. Armed with experience in the clinical and research spheres of both mental health, and drugs and alcohol, Amanda's input into the Faculty of Health and Medicine has been
invaluable. Her attention shifted from teaching and research to research in 2003, where has been continuously funded by NHRMC fellowships ever since. Known as a generous mentor and supporter of early career researchers, Amanda was appointed Deputy Head of the School of Medicine and Public Health (Research)
in 2010 for a three year term.

METHAMPHETAMINE TREATMENT OPTIONS

A consistent area of focus in Amanda's research has been the use of methamphetamines by people with mental health problems. Leading a Commonwealth funded trial in the early 2000s, Amanda found counselling to have favourable outcomes for methamphetamine users. The treatment framework was disseminated
nationally, but unfortunately, the model was not sustained.

Amanda points to several factors including poly-drug use, presenting behaviours such as paranoia or violence, and sector worker turnover as barriers to methamphetamine users accessing drug and alcohol services.

"Methamphetamine is the drug that makes you confront that overlap between mental health and substance use," she says.

"It really draws out the psychotic symptomatology and edginess in people."

"Users can be angry or violent, and workers need training to be confident on how to proceed from there."

As immediate past president of the Australasian Professional Society for Alcohol and other Drugs (APSAD) Amanda represented this peak body in consultations with the Federal Government's National Ice Taskforce. Called upon to help inform the community response to ice use as a major public health issue
in Australia, she presented at the National Methamphetamine Symposium in early May 2015.

WHERE THERE'S SMOKE

More recently, another drug has almost completely captured Amanda's attention.

"In the last ten years or so I have become very interested in tobacco, the drug that everyone forgets."

"Because it is legal, people don't understand that it can create so much harm," she adds.

Amanda has been an advisor during the transition of forensic hospitals to smoke-free facilities, and is currently working on a phone delivered smoking cessation program for people with mental health problems in partnership with Quitline Victoria.

"I'm very passionate about trying to help people with mental health problems give up smoking," she declares.

"They die 20 years earlier than people in the general community from tobacco related causes."

Amanda is also currently involved in an NHMRC trial, testing the efficacy of iPad delivered smoking cessation programs targeting hospital patients who have suffered orthopaedic trauma.

The trial, led by Associate Professor Billie Bonevski, is attempting to decrease the healing time and amputation risk of participants by helping them quit smoking.

WHERE TO FROM HERE

When asked about her future, Amanda conveys her enthusiasm for the Quitline telephone delivered smoking cessation program. She sees this as her direct future, evaluating phone interventions in real life delivery.

"I think telephone interventions are where I can make an impact," she avows.

"But we have proved that phone intervention, which everyone loved, was simpler, briefer and just as effective."

Amanda also speaks eagerly about a related project she is undertaking with Doctor Peter Kelly from the University of Wollongong. This project trains peer workers to deliver healthy living interventions with a focus on diet and activity, to people with mental health problems, again via telephone.

Although it may seem incongruous for Amanda to be focusing on diet and activity she points out that changing dietary intake (like levels of fruit and vegetables) and reducing TV watching may impact positively on the other behaviours that affect cardio-vascular health – smoking, alcohol, and snacking
on high fat foods.

"They are all addictive behaviours," she explains.

"In today's society, you can buy so much food, so much packaged food. Forty years ago it wasn't available. Food really is the new tobacco."

Career Summary

Biography

Amanda Baker is a National Health and Medical Research Council (NHMRC) Senior Research Fellow employed as a Professor in the School of Medicine and Public Health at the University of Newcastle, NSW.Her research has been supported by NHMRC fellowships continuously since 2003, supplemented by a Trans-Tasman Award (2013-2017). Funded in 2012 by the NHMRC, Amanda is Co-Director of the NHMRC Centre of Research Excellence (CRE) in Mental Health and Substance Use, which aims to build much needed research capacity in this area. This CRE represents a world first, bringing together the largest concentration of nationally and internationally recognised comorbidity researchers. Professor Baker has worked as a clinical psychologist in mental health, substance abuse and forensic treatment settings in Australia and the UK.

Vision: Professor Baker’s vision is to lead a research program to transform the treatment of a co-occurring triad of disorders that are of utmost importance to health and that have major social and economic ramifications: comorbid mental, substance use and physical disorders. Premature death associated with this comorbidity triad costs Australia around $15 billion a year. With 8 current NHMRC grants, her program of research into effective psychological interventions for these comorbidities is set to have a very significant impact on comorbidity health service delivery and research capacity. Projects are designed and undertaken in partnership with end-user organisations, augmenting feasibility and maximising impact. Research questions address issues of high priority to practitioners; findings are immediately available to inform partners’ decision-making, accelerating translation; knowledge-exchange is integral and builds capacity of researchers and clinicians in applied research partnerships; and multi-disciplinary expertise and academic and end-user infrastructure are leveraged to their full potential.

Research output: Professor Baker has over 230 publications. These include 185 articles (45 as first author) in peer-reviewed journals. She has edited 2 books, has 36 book chapters, 20 treatment manuals, and 6 clinician guidelines. Amanda has an h-index of 41 (Google Scholar) and a total of 3,314 citations (Scopus, May 2017). Since 2000, Amanda has been a Chief Investigator on 19 NHMRC grants (total $13.33M), including 8 as CIA. These projects have typically involved multi-site randomised controlled trials of psychological interventions among people with severe mental disorders and substance use problems. Amanda’s total research income since appointment to the University of Newcastle in 1995 is $22.36M.

National and international profile: Professor Baker collaborates with leading international researchers, including Professor Bonnie Spring from Northwestern University, Chicago (a past President of the American Society for Behavioural Medicine), with whom she has submitted current NHMRC and US NIMH grant applications; and Professor Jill Williams from Robert Wood Johnson Medical School, Rutgers University, USA, with whom she has received two NHMRC grants. As well as co-directing the NHMRC CRE in Comorbidity Research with Professor Maree Teesson at UNSW, Amanda has held several national competitive grants with Professor Robyn Richmond (UNSW).

Supervision and contribution: Professor Baker mentors early career researchers, several of whom are now NHMRC Fellows, and has supervised a total of 27 RHD students. She currently supervises 9 PhD and 4 Masters students.

Professor Baker has been a member of the NSW Health Department Centre for Drug and Alcohol Research Advisory Committee (2006-2009), the NHMRC Training Fellowship Population Health Review Panel (2008-2011), the NHMRC Project Grants Review Panel (2009, 2011) and the NHMRC Assigner’s Academy (2013, 2014, 2015). She serves on the Editorial Board of APSAD’s journal, Drug and Alcohol Review, as a Deputy Editor (2007-present) and was its Book Review Editor from 2000-2006. Amanda was appointed Deputy Head of School - Research (School of Medicine and Public Health, Faculty of Health, University of Newcastle) from 2010-2013.

Qualifications

PhD, University of New South Wales

Master of Psychology, University of Sydney

Bachelor of Arts (Psychology), University of New South Wales

Keywords

CBT

Comorbidity

Psychosis

Substance Use

clinical trials

depression

mental health

psychological treatment

Fields of Research

Code

Description

Percentage

110399

Clinical Sciences not elsewhere classified

20

111799

Public Health and Health Services not elsewhere classified

35

170199

Psychology not elsewhere classified

45

Professional Experience

UON Appointment

Title

Organisation / Department

Professor

University of NewcastleSchool of Medicine and Public HealthAustralia

Academic appointment

Dates

Title

Organisation / Department

1/01/2009 -

Senior Fellow

Gladys M Brawn Memorial FellowshipAustralia

1/01/2008 - 31/03/2010

Deputy Director

University of NewcastlePrioirty Research Centre for Brain and Mental Health ResearchAustralia

1/01/2008 - 31/12/2010

Deputy Head of School (Research)

University of Newcastle - Faculty of Health and Medicine, School of Medicine and Public HealthAustralia

1/01/2007 -

Editor - Mental Health and Substance Use: Dual Diagnosis Journal

Mental Health and Substance Use: Dual Diagnosis Journal Australia

1/05/2004 -

Conjoint Academic

The University of New South WalesAustralia

1/01/2003 -

Fellow NHMRC

NHMRC - Research Fellowships Scheme

National Health & Medical Research Council

1/01/2001 -

Editor - Drug and Alcohol Review Journal

Drug and Alcohol Review JournalAustralia

1/09/1991 - 1/12/1994

Conjoint Lecturer

The University of SydneyAustralia

1/07/1989 - 1/09/1991

Clinical Psychologist

The University of New South WalesNational Drug and Alcohol Research CentreAustralia

Membership

Dates

Title

Organisation / Department

1/01/2006 -

Membership - Australian Professional Society for Alcohol and Other Drugs

Australian Professional Society for Alcohol and Other DrugsAustralia

Professional appointment

Dates

Title

Organisation / Department

1/10/2016 -

Academic Mentoring Program Leader

University of Newcastle - Faculty of Health and Medicine, School of Medicine and Public HealthAustralia

1/07/2009 -

Professor

University of Newcastle - Faculty of Health and Medicine, School of Medicine and Public HealthAustralia

Lee NK, Kay-Lambkin FJ, McKetin R, Baker AL, 'Everything old is new again: The application of drug treatment to the emerging challenge of methamphetamine use and dependence', Drugs and Public Health: Australian Perspectives on Policy and Practice, Oxford University Press, Oxford 73-84 (2008) [B1]

Baker AL, Lee N, 'Amphetamines', National Centre for Education and Training on Addiction (NCETA) Consortium. Alcohol and Other Drugs: A Handbook for Health Professionals, Australian Government Department of Health and Ageing, Canberra (2004)

Baker AL, Reichler H, 'Evidence based treatment for alcohol and other drug problems: A review with clinical guidelines', Focusing the Mind: Effective and Innovative Interventions in Counselling and Psychotherapy, Central Institute of Technology, Upper Hutt, New Zealand (1999)

1997

Baker AL, 'Brief interventions for alcohol and illicit drug problems: A review', The Long and the Short of Treatment for Alcohol and Drug Disorders, Department of Psychological Medicine, Christchurch School of Medicine, Christchurch, New Zealand (1997)

Kelly PJ, Baker AL, Kay-Lambkin F, 'ADDRESSING MULTIPLE HEALTH RISK BEHAVIOURS IN DISADVANTAGED POPULATIONS: RESEARCH BEING LED BY THE NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL CENTRE OF RESEARCH EXCELLENCE IN MENTAL HEALTH AND SUBSTANCE USE', DRUG AND ALCOHOL REVIEW, 33 37-37 (2014) [E3]

Hiles SA, Baker AL, De Malmanche T, Attia JR, 'A meta-analysis of differences in IL-6 and IL-10 between people with and without depression: Exploring the causes of heterogeneity', Brain, Behavior, and Immunity, 26 1180-1188 (2012) [C1]

Pregnant injecting drug users were randomly assigned to: (i) individually receive a six-session cognitive-behavioural intervention in addition to their usual methadone maintenance treatment (intervention condition (I) (n = 40)); or (ii) their usual methadone maintenance treatment only (control condition (C) (n = 40)). There was no change in drug use per se in either group after the intervention. However, at 9-month follow-up the I group had significantly reduced some HIV risk-taking behaviours (in particular injecting risk behaviours). The I group reduced the needle risk associated both with 'typical' use (drug use in the month before interview) and 'binge' use (drug use in the month nominated as the heaviest month of drug use in the previous 6 months). The intervention had no effect on sexual risk behaviours. The finding of reduced injecting risk behaviour following the six-session intervention suggests that such an i ntervention may be of benefit for individuals persisting with injecting risk behaviours despite methadone maintenance treatment and the availability of sterile injection equipment.

Despite neuroleptic medication, many schizophrenic patients continue to experience residual positive psychotic symptoms. These residual symptoms cause distress and disability. We report a controlled trial of two cognitive-behavioural treatments to alleviate residual hallucinations and delusions. Forty-nine patients were recruited into the trial, of whom 27 entered the trial and completed post-treatment assessment, and 23 were assessed at six-month follow-up. Patients were randomly allocated to either coping strategy enhancement (CSE) or problem solving (PS). Half the patients were allocated to a high-expectancy positive demand condition and half to a counter-demand condition to evaluate expectations of improvement. Patients receiving either cognitive-behavioural treatment showed significant reductions in psychotic symptoms compared with those in the waiting period, who showed no improvement. There was some evidence, although equivocal, that patients receiving CSE improved more than those receiving PS. There was no evidence that improvements generalised to negative symptoms or social functioning, nor was there evidence that expectancy of treatment benefit contributed to the treatment effect.

Objective: To evaluate the effectiveness of relapse prevention (RP) and brief intervention (BI) in reducing HIV risk-taking behaviours among injecting drug users (IDU) enrolled in methadone programmes. The hypotheses tested were: (1) that a six-session RP programme would be more effective in reducing HIV risk-taking behaviours than a one-session BI and a non-intervention control condition (C); and (2) that BI would be more effective in reducing HIV risk-taking behaviours than C. Design: Clients of methadone programmes were randomly assigned to either RP, BI, or C. Follow-up occurred 6 months after pre-intervention assessment and was conducted by independent research assistants who were not aware of subjects' group allocations. Setting: Confidential assessment interviews and interventions generally took place at the methadone unit treating the subject. Participants: Ninety-five IDU enrolled in methadone programmes. Study entry criteria were: injection of any drug in the 6 months before the day of pre-intervention assessment; literacy in English; agreement to HIV-antibody testing for research purposes; and no known diagnosis of a serious mental illness. Eighty subjects were contacted successfully for a 6-month follow-up. Interventions: The RP intervention was a six-session programme. Each 60-90-min session was conducted individually. The BI was a one-session motivational interview lasting 60-90min, accompanied by a self-help booklet. Main outcome measures: All subjects were administered the Drug Use Scale and HIV Risk-Taking Behaviour Scale of the Opiate Treatment Index and consented to the collection of a capillary blood sample for HIV-antibody testing at pre-intervention assessment and follow-up. At follow-up, the Highest HIV Risk-Taking Behaviour Scale, collateral reports from subjects' sexual partners pertaining to the previous month and urinalysis results for the month before follow-up were collected. Results: Compliance with interventions was good. Correspondence of self-reports with urinalysis and collateral reports was satisfactory. There were no significant differences between groups in risk-taking behaviours during the month before follow-up. However, there was evidence of a lower rate of needle-risk behaviour (sharing and cleaning) during the heaviest risk-taking month since pre-intervention assessment in the group given RP. There were no indications that BI was of greater benefit than the usual methadone treatment and neither intervention appeared to reduce sexual risk behaviour. Conclusions: The results are cautiously interpreted as showing that individual RP programmes decrease the level of needle-risk behaviour during relapse episodes, but further research is required to replicate this finding.

Startup MJ, Carr VJ, Baker AL, Schall UA, Stain HJ, 'Specificity of the effects of CBT in the prevention of transition among young people at ultra-high risk of developing a psychotic disorder', Australasian Society for Psychiatric Research (ASPR) 2011 Conference: From Idea to Implementation, Dunedin, NZ (2011) [E3]

Baker AL, 'Stoned, cold sober: Psychological interventions for cannabis and alcohol use among people with psychosis and major depression', 2nd International Cannabis and Mental Health Conference: Programme and Abstract Book, London (2007) [E3]

Baker AL, Reichler HM, 'Evidence based treatment for slcohol and other drug problems: A review with clinical guidelines', Focusing the mind: effective and innovative interventions in counselling and psychotherapy, New Zealand (1999) [E1]

Other (1 outputs)

Year

Citation

Altmetrics

Link

2017

Baker AL, 'Editorial: Building a Research Agenda for Reducing Smoking and Other Cardiovascular Risk Factors', Editorial: Building a Research Agenda for Reducing Smoking and Other Cardiovascular Risk Factors (2017)

Baker AL, Bucci SR, Kay-Lambkin FJ, 'Intervention for Alcohol, Cannabis and Amphetamine Use among People with a Psychotic Illness', National Drug & Alcohol Research Centre, Faculty of Medicine, University of New South Wales, 100 (2004) [R1]

PhD (Psychiatry), Faculty of Health and Medicine, The University of Newcastle

Principal Supervisor

2012

PhD

The Antidepressant Effects of of Exercise Among Young People: Pathways to Change; Mind, Body or Behaviour?

PhD (Psychiatry), Faculty of Science, The University of Newcastle

Principal Supervisor

2012

PhD

The Antidepressant Effects of of Exercise Among Young People: Pathways to Change; Mind, Body or Behaviour?

PhD (Psychiatry), Faculty of Health and Medicine, The University of Newcastle

Principal Supervisor

2009

PhD

A Randomised Clinical Trial of Dialectical Behaviour Therapy and Conversational Model for the Treatment of Borderline Personality Disorder: A Hybrid Efficacy-Effectiveness Study in a Public Sector Mental Health Service in Australia

PhD (Psychiatry), Faculty of Health and Medicine, The University of Newcastle

Principal Supervisor

Past Supervision

Year

Level of Study

Research Title

Program

Supervisor Type

2017

PhD

Increasing the Implementation of Evidence Based Care for Head and Neck Cancer Patients

PhD (Clinical Psychology), Faculty of Science, The University of Newcastle

Co-Supervisor

2015

PhD

Cigarette Smoking and Psychosis: An Examination of Motivations and Cognitive Factors

PhD (Psychiatry), Faculty of Health and Medicine, The University of Newcastle